Fertility treatment, twin births, and unplanned pregnancies in women with eating disorders: findings from a population-based birth cohort.
Fertility treatment, twin births, and unplanned pregnancies in women with eating disorders: findings from a population-based birth cohort.
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饮食失调女性的生育治疗、双胞胎出生和意外怀孕：基于人口的出生队列的研究结果。
DOI：
10.1111/1471-0528.12503
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发表时间：
2014-03
期刊：
影响因子：
--
通讯作者：
Tiemeier H
中科院分区：
文献类型：
--
作者：
Micali N;dos-Santos-Silva I;De Stavola B;Steenweg-de Graaff J;Jaddoe V;Hofman A;Verhulst FC;Steegers E;Tiemeier H
在一个基于人群的样本中调查饮食失调孕妇的生育治疗、双胞胎和计划外妊娠。基于人口的纵向出生队列（R世代）。荷兰的鹿特丹。将R世代研究中报告有（近期或既往）神经性厌食症（n = 160）、神经性贪食症（n = 265）或两者兼而有之（n = 130）病史以及除进食障碍外的精神疾病病史（n = 1396）的女性与无精神疾病的女性（n = 4367）进行比较。使用逻辑回归对研究结果进行比较。我们进行了粗分析和调整分析（调整相关混杂因素）。生育治疗，双胞胎，计划外怀孕，以及女性对计划外怀孕的感受。相对于没有精神疾病的女性，患有神经性贪食症的女性接受生育治疗的几率增加（比值比，OR，2.3; 95%置信区间，95% CI，1.1-5.2）。患有所有进食障碍的女性双胞胎的几率增加（神经性厌食症，OR 2.7，95% CI 1.0-7.7;神经性贪食症，OR 2.7，95% CI 1.1-6.6;神经性厌食症和贪食症，OR 3.795% CI 1.3-10.7）。神经性厌食症与计划外怀孕的几率增加（OR 1.8，95% CI 1.2-2.6）和对这些怀孕的复杂感受（校正OR 5.0，95% CI 1.7-14.4）相关。孕前体重指数不能解释观察到的相关性。饮食失调与接受生育治疗和双胞胎的几率增加有关。患有神经性厌食症的女性更有可能意外怀孕，并且对意外怀孕有复杂的感觉。生育治疗专家应该意识到，活动和过去的饮食失调（神经性厌食症和神经性贪食症）可能是生育问题的基础。
To investigate fertility treatment, twin births, and unplanned pregnancies in pregnant women with eating disorders in a population-based sample. A longitudinal population-based birth cohort (Generation R). Rotterdam, the Netherlands. Women from the Generation R study who reported a history of (recent or past) anorexia nervosa (n = 160), bulimia nervosa (n = 265), or both (n = 130), and a history of psychiatric disorders other than eating disorders (n = 1396) were compared with women without psychiatric disorders (n = 4367). Women were compared on the studied outcomes using logistic regression. We performed crude and adjusted analyses (adjusting for relevant confounding factors). Fertility treatment, twin births, unplanned pregnancies, and women's feelings towards unplanned pregnancies. Relative to women without psychiatric disorders, women with bulimia nervosa had increased odds (odds ratio, OR, 2.3; 95% confidence interval, 95% CI, 1.1–5.2) of having undergone fertility treatment. Women with all eating disorders had increased odds of twin births (anorexia nervosa, OR 2.7, 95% CI 1.0–7.7; bulimia nervosa, OR 2.7, 95% CI 1.1–6.6; anorexia and bulimia nervosa, OR 3.795% CI 1.3–10.7). Anorexia nervosa was associated with increased odds of unplanned pregnancies (OR 1.8, 95% CI 1.2–2.6) and mixed feelings about these pregnancies (adjusted OR 5.0, 95% CI 1.7–14.4). Pre-pregnancy body mass index did not explain the observed associations. Eating disorders are associated with increased odds of receiving fertility treatment and twin births. Women with anorexia nervosa were more likely to have an unplanned pregnancy and have mixed feelings about the unplanned pregnancy. Fertility treatment specialists should be aware that both active and past eating disorders (both anorexia nervosa and bulimia nervosa) might underlie fertility problems.
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